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Thursday, 20 October 2016

Disabled Generals and the Truth!

The media reported a letter written by a former Director General of Armed Forces Medical Services on the subject of disability benefits to officers of the rank of Major General and above. Though the media reported the issue objectively without taking sides, the mere existence of such a letter causes concern and also paints an untrue picture of the entire military establishment besides causing fissures between various ranks. I have penned a detailed opinion piece on the subject which appears in Swarajya Magazine :

DISABLED GENERALS AND THE TRUTH

Navdeep Singh

It was bewildering to see the circulation of a letter purportedly written in 2014 by the then Director General Armed Forces Medical Services (DGAFMS) to the Defence Secretary insinuating that Generals of the Army were wrongly claiming disability benefits for personal gain. Of course it got wide coverage, and amongst others, the following points were raised in the said communication:

Generals present themselves with disabilities at the fag end of their careers and doctors working in hospitals under their command find themselves constrained to oblige “these officers”.

The provision of post-discharge claims is being misused for claiming benefits for disabilities such as corns, eczema and hearing loss.

That Generals should be examined at a central place and not in establishments under their command.

That disability pension claims should be decided two years prior to retirement and tax benefits should be abrogated.

Concept of a disability arising in a peace area or field should be done away with and any disability occurring in any area should be taken as connected with service and entitling a person to disability benefits.

One by one, let me attempt to clear this muddle:

Generals presenting themselves with disabilities at the fag end of their careers and doctors obliging them

The DGAFMS should have known that medical science is not mathematics wherein disabilities can be controlled or planned. Generals retire at the age of 58 onwards and the likelihood of incurring certain disabilities is higher at such an age profile and merely because a person attains a higher rank cannot be considered a disqualification from flow of benefits entitled under the rules. The rules do not discriminate between a Sepoy or a General and even this author is personally aware of many instances wherein senior officers developed diseases towards retirement, including Coronary Heart Disease, Ischemic Heart Disease necessitating angioplasty and even open heart surgery, and also back problems. So is the DGAFMS implying that a senior rank shields a person from disease? It should be absolutely clear that unless it is shown that a person has feigned a disability (used to happen in the times of yore when diagnostic tools were not advanced- with hearing loss and backache being the most commonly faked disabilities which could not be objectively discerned), there is no question of discriminating a person based on rank. Interestingly much water has flown from the date this letter was written by the DGAFMS and which factum has not been reported by any of the media houses and this very issue had been duly deliberated upon by a Committee of Experts constituted on the directions of theRaksha Mantri, of which this author too was Member and which recorded its conclusion on this subject in the following words:

“…The Committee notes that the rank of a claimant is immaterial for claiming disability pension if admissible under the rules, however cases of feigning disabilities where none exist should be dealt with strongly and medical boards should also be extra careful in examining cases where individuals have reported with a medical condition just before retirement.”

Hence, instead of scandalizing the issue out of proportion, the DGAFMS could have simply written to all medical authorities to exercise due care. Moreover, if medical boards, in the opinion of the DGAFMS, were being pressurized by senior officers, then the fault lies with those medical boards which are under the overall command of the DGAFMS for being so fickle. Also, if the DGAFMS felt that officers were declaring themselves fit during the most part of their careers and disclosing their disabilities just before retirement, then it is again the fault of the annual and periodic medical boards for not being able to identify disabilities and lowering the medical categorization of officers at the correct time. It was an issue that could have been resolved in-house and the Defence Secretary had nothing to do with this malaise, if any. Also, it is none of the concerns of the DGAFMS about the relationship between career advancement of officers and their disabilities and the medical board cannot go beyond certifying the disability and its connection with service.

Post-discharge claims for corns, eczema and hearing loss

This is a surprising averment. Firstly, the rules provide for the system of post-discharge claims for both civilians as well as defence retirees. Secondly, merely submitting such a claim does not result in grant of benefits and a proper medical board is still held to confirm whether the disability was such that could have had a basis in service but fully manifested itself after retirement and whether it had a service-connection or not, and the said exercise is to be conducted by the office of the DGAFMS itself through a proper medical board. Floating a claim by a General does not mean the automatic grant of such a benefit. Moreover, medical documents of the disability under consideration initiated during the course of service are always required to be produced for any such claim to be accepted. Regarding eczema and corns, it seems that the two medical conditions have been mentioned in the letter just for effect, and I would be surprised if any person after retirement has been granted disability benefits for these two disabilities at all, and in case true, then the number would be negligible and if this hunch of mine is correct then the argument of the then DGAFMS self-destructs. However, to add, if such instances are true, I agree that disability benefits for such minor ailments giving rise to no functional problems should not be considered after retirement. On the point of hearing loss, I think that the then DGAFMS should have been in a better position to understand that noise above 85-90 decibels is harmful to the ear and even a single gunshot over 140 decibels can damage the ear. The 5.56 shot of the standard issue infantry weapon produces a sound of over 150 decibels and there is no system of using hearing protection devices in the Indian Army. All troops of all ranks undertake regular firing practices all throughout their careers and hence cases of hearing loss should not have been broad-brushed in such a manner by the highest medical authority of the Armed Forces casually unless there was diagnostic evidence to prove that a particular General had faked his disability. The office of the DGAFMS should restrict itself to commenting whether a disability exists or not and if a person is faking a disability, it should raise the red flag, nothing more, nothing less.

That Generals should be examined at a central place and not under hospitals under them

Wonderful idea that should be acceptable to all stakeholders since it would reflect objectivity in the entire process and offset any conflict of interest. The letter of the DGAFMS should have limited itself to this aspect instead of casting aspersions on senior ranks of the defence services. Going a step further, medical boards could be held at hospitals of other services. For example, if a Major General of the Army is being examined, the board could be held at an Air Force establishment, and vice versa.

That disability pension claims should be decided two years prior to retirement and tax benefits should be abrogated

A ridiculous suggestion, to say the least, which unfortunately also shows the lack of knowledge of basic disability law by the highest medical authority. As per law, disability benefits are determined on the basis of Release and Invalidation Medical Boards at the time of release from service and the medical condition persisting at the time of severance from service, and not earlier. Also, why should a General be held responsible only because a disability emerges at the later stages of his career? While calling for abrogation of tax benefits, the then DGAFMS has transgressed all limits of his jurisdiction. What is he? The Chairperson of the Central Board of Direct Taxes? The Finance Secretary?

Concept of disability arising in a peace area or field should be done away with and any disability occurring in any area should be taken as connected with service entitling a person to disability benefits

Very pertinent suggestion and to support the DGAFMS I would forcefully state that this is already provided under the rules which prescribe that incurring of a disability in a peace or field area has no implication on disability benefits. However, there is a twist to this. Despite this rule and various High Courts and the Supreme Court adversely commenting upon the peace/field distinction perpetrated by military medical boards, it is the same office of the DGAFMS which has illegally, and in contravention of rules, issued personal and Demi Official letters to medical establishments asking them not to consider cases of certain disabilities arising in peace areas. The same office of the DGAFMS has also illegally omitted to reproduce the beneficial disability rules to the said effect while compiling its “Guide to Medical Officers, Military Pensions”. It is therefore ironic that after issuing illegal communications to its lower formations and also issuing guidelines contrary to rules, the senior most authority of the said office makes a somersault and talks of something that his own office is responsible for. In fact, this suggestion, though very much relevant and correct, is contrary to the first part of the DGAFMS’s communication to the Defence Secretary. The DGAFMS therefore is suggesting that though all disabilities incurred in service should (rightly) qualify for disability benefits, if the disabled officer happens to shoulder a heavier brass, he or she should be disentitled. It would have been in the fitness of things if all of us had rather been deeply concerned about the fact that defence personnel of all ranks are dying earlier than their civilian counterparts due to a deteriorating health profile and increase in stress and strain of service. In any case, the issue has been decided in detail by the High Courts and the Supreme Court, and any aberration suggested would not just be unethical but also contemptuous. The entire length and breadth of the matter has also been deliberated upon in much detail in Paragraph 2.2.1 of the ibid Committee of Experts which thrashed out the subject from all corners.

To conclude, I would only say that the issue of disability benefits to our soldiers of all ranks is much too sensitive to be discussed without due background or with little knowledge and such matters which involve precious rights of our troops concerning their health, irrespective of their rank, cannot be held hostage to a short three page note which turns the entire law and practical realities upside down. Also, assuming that there had been a few undeserving cases or rotten apples, which could anyway be counted on our fingertips where disabilities were supposedly faked, though not quite an agreeable proposition, the responsibility of letting such disabilities pass rests squarely on the multiple medical boards which allowed the same to happen and then the medical authorities who approved them- all of whom function under the office of the DGAFMS.

The letter therefore clearly appears to have been written with a background, and dare I say it, with a foreground. It is yet another matter of concern that the subject that should have been addressed to the three Chiefs of the Defence Services was endorsed to the then Defence Secretary who had no role in the subject thereby providing a leverage to many elements within the system to inject further chaos in the matter.

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